Russotto Antonino, Rolfini Edoardo, Paladini Giovanni, Gastaldo Claudia, Vicentini Costanza, Zotti Carla Maria
Department of Public Health and Paediatrics, University of Turin, 10126 Turin, Italy.
Antibiotics (Basel). 2023 Mar 15;12(3):583. doi: 10.3390/antibiotics12030583.
Hand hygiene (HH) is one of the most important infection prevention and control strategies at the hospital level. The aim of this study was to evaluate the potential COVID-19 pandemic impact on HH practices and rate of healthcare-associated infections. Data on alcohol-based handrub consumption (AHC) and antimicrobial resistance across 27 Italian hospitals over the period 2017-2021 were considered. Data on Methicillin-resistant (MRSA) and carbapenem-resistant Enterobacteria (CRE) were extracted from the antimicrobial resistance regional surveillance system. A significant increase was highlighted, with a peak in 2020 and a partial fall in 2021 for AHC ( < 0.001). The decrease in MRSA rates in 2021 compared to 2017-2019 was significant ( = 0.013). A significant Spearman's correlation between AHC and CRE rates was found (Spearman's ρ -0.646, = 0.032). This study supports the importance of AHC monitoring and showed that improving AHC was an attainable goal in the COVID-19 era. However, other strategies are needed to maintain the high levels of AHC attained during the pandemic, in order to avoid a progressive drop that has already begun in 2021. Furthermore, our results support the inverse relationship between AHC and infection rates and antimicrobial-resistant bacteria.
手卫生是医院层面最重要的感染预防与控制策略之一。本研究的目的是评估新冠疫情对医院手卫生措施及医疗相关感染发生率的潜在影响。我们考量了2017 - 2021年期间意大利27家医院基于酒精的洗手液消耗量（AHC）及抗菌药物耐药性的数据。耐甲氧西林金黄色葡萄球菌（MRSA）和耐碳青霉烯类肠杆菌科细菌（CRE）的数据是从抗菌药物耐药性区域监测系统中提取的。研究突出显示了AHC显著增加，在2020年达到峰值，2021年有所下降（<0.001）。与2017 - 2019年相比，2021年MRSA发生率的下降具有显著性（=0.013）。研究发现AHC与CRE发生率之间存在显著的斯皮尔曼相关性（斯皮尔曼ρ=-0.646，=0.032）。本研究支持了监测AHC的重要性，并表明在新冠疫情时代提高AHC是一个可实现的目标。然而，需要采取其他策略来维持疫情期间达到的高水平AHC，以避免已经在2021年开始的逐步下降。此外，我们的结果支持AHC与感染率及抗菌药物耐药菌之间的负相关关系。
